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State of Wisconsin Wisconsin Funeral and Cemetery Aids Program Manual Release 22-01 May 2, 2022 |
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State of Wisconsin Wisconsin Funeral and Cemetery Aids Program Manual Release 22-01 May 2, 2022 |
1.3 Potentially Eligible Decedents
1.4 Confirming Potential Eligibility
1.6 Posthumous Health Care Application
The WFCAP program is authorized under Wis. Stat. § 49.785
The Wisconsin Funeral and Cemetery Aids Program (WFCAP) is a voluntary assistance program for service providers who offer funeral, cemetery, and cremation services to certain decedents (reference Section 1.3 Potentially Eligible Decedents), and whose services are not fully compensated by the decedent’s estate, family, or other resources. WFCAP is the payer of last resort. Therefore, service providers are required to make a reasonable effort to exhaust all other funding sources before submitting a WFCAP Application. Other funding sources include, but are not limited to: burial trusts, burial insurance, estate assets, and fundraisers.
**Any suspected fraud will be referred to the Office of the Inspector General. **
The Wisconsin Department of Health Services (DHS), Division of Medicaid Services administers WFCAP. Administration includes paying funeral, cemetery, and crematory service providers in accordance with the payment policies in this manual.
Telephone: 888-859-0611
Fax: 608-710-6712
Email: dhswfcapapplications@wi.gov
Address:
Department of Health Services
Division of Medicaid Services
Bureau of Operations Management
ATT: Wisconsin Funeral and Cemetery Aids Program
PO Box 309
Madison, WI 53701-0309
Note: Fax or email are the preferred methods for application and documentation submission.
DHS may issue WFCAP payments for the unmet funeral, cemetery, and crematory expenses of a person who on the confirmed date of death, met at least one of the following criteria:
The decedent was a Wisconsin Works (W-2 ) participant (paid placement only).
The decedent was a child for whom a Caretaker Supplement (CTS ) or Kinship Care benefit was being made on their behalf.
The decedent was an Elderly Blind Disabled categorically needy EBD -related Medicaid individuals, except for Medicaid Purchase Plan (MAPP ).
The decedent was a parent or caretaker relative receiving BadgerCare Plus with family income that does not exceed 50% of the federal poverty level.
The decedent was a child receiving foster care or adoption assistance.
The decedent was a child under age six or was a pregnant woman receiving BadgerCare Plus with family income that did not exceed 185% of the federal poverty level.
The decedent was a child at least age six, but not yet 19, receiving BadgerCare Plus with family income that did not exceed 100% of the federal poverty level.
The decedent was a person eligible for categorically or medically needy institutional Medicaid at the time of death.
The decedent participated in one of Wisconsin's Home and Community-Based Waiver Programs, including IRIS (Include, Respect, I Self-Direct), or community waiver Medicaid Purchase Plan (MAPW ).
The decedent was a member of Family Care.
The decedent was a Tuberculosis-Related (TB-Related) Only Medicaid recipient.
The decedent was the fetus of a woman in a WFCAP-qualifying Medicaid or BadgerCare Plus category as identified in Section 1.3 Potentially Eligible Decedents.
The decedent was a participant in the Katie Beckett Program.
The decedent was a Supplemental Security Income (SSI), SSI State Supplement (SSI-SSP), or SSI Medicaid recipient who was a Wisconsin resident.
The decedent was an individual who met a Medicaid deductible and also qualified for a home-based program.
Note: There may be additional conditions that the decedent must have met on the confirmed date of death winthin the above programs in order to be considered potentially eligible.
Funeral, cemetery, and crematory expenses will not be paid for any individual who did not meet at least one of the above criteria on the confirmed date of death.
Note: When requesting payment for a stillborn of a Medicaid member, or live birth of a Medicaid member, service providers must provide all required demographic information for the Medicaid member on the application. In addition, the mother's name, Social Security number, and date of birth are required.
Providers are encouraged to contact WFCAP after the confirmed date of death by phone, fax, or email to check for potential program eligibility before submitting an application. This potential eligibility query is only for determining if the decedent met at least one of the criteria identified in Section 1.3 Potentially Eligible Decedents. Letters for potential eligibility will not be provided by WFCAP. WFCAP payment eligibility is determined after review and processing of the complete WFCAP Application, F-10141.
WFCAP will not provide any information about potential eligibility to providers regarding individuals who are still alive. A Confirmed date of death is required in order to check for potential program eligibility.
If a decedent was not enrolled in one of the programs identified in Section 1.3 Potentially Eligible Decedents at the time of death, the service provider may still qualify for a WFCAP payment for the decedent’s expenses if at the time of death or due to the cause of death, the decedent was eligible for Medicaid. Prior to the service provider submitting a WFCAP application, the decedent’s representative or family must contact the decedent’s income maintenance agency for a posthumous application to determine if the decedent was eligible for Medicaid. WFCAP does not determine income maintenance eligibility. Therefore, WFCAP cannot answer any questions regarding eligibility for decedents beyond stating 'potentially eligible' or 'not eligible.'
This page last updated in Release Number: 22-01
Release Date: 05/02/2022
Effective Date: 05/02/2022
